My employer offers health insurance. My cost per month after the employers contribution is $350 per month. I can’t afford this. I recently obtained coverage through the marketplace and I am paying $197.00 a month.

I asked my employer if she would contribute the $150 she contributes to the other employees who can’t afford the coverage she is offering and was told no. That she only contributes if I chose the plan she has offered me.

My question is : Does she have to contribute towards my chosen plan since I can’t afford the plan she offered me? If so can you please send me some literature to present to her.

I would greatly appreciate any advice or help you can offer.


Answer

Your employer only has to contribute to a health plan they offer. You can't use cost assistance if they offer coverage. That being said, if the plan you are being offered costs more than 9.5% of your household income after deductions, then you can get an exemption from the Marketplace due to unaffordable employer coverage.

If your employer wanted to fund your individual premium there are a set of rules to follow. They can be found in IRS notice 2013-54.

Here is the HealthCare.Gov page on unaffordable coverage.

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